Gut-on-a-chip: Mimicking and monitoring the human intestine

Over the last few years, the intestine has been extensively studied using in vitro microfluidic systems, commonly known as gut-on-a-chip (GOC) devices. This interest has been due not only to the importance of the intestine's proper functions but also to the relationship that this organ and the microbiota that inhabits it has with the rest of the body's organs. The increased complexity of these in vitro systems, together with the need to improve our understanding of intestinal physiology interdependencies, has led to greater focus on the integration of biosensors within these devices. However, the current number of GOC devices with integrated sensors for monitoring relevant physiological parameters are very limited and demand the use of external analytical techniques that delay the analysis and prevent real-time decision-making. This paper reviews the various materials, technologies, and structures that have been used both for mimicking the physiology of the intestine and monitoring relevant physiological parameters, such as permeability of the gut barrier, dissolved oxygen concentration, cytokines profile and the production of microbial short-chain fatty acids. We also propose alternative biosensing techniques demonstrated in other in vitro and lab-on-a-chip devices that could be translated to GOC models. A critical analysis of the requirements, limitations, and current challenges on the microenvironment replication and monitorization of GOC models is included, with a particular focus on the physiological parameters and biomarkers that should be detected simultaneously in real-time to get a proper framework of the gut function that until now, have not received the necessary attention.